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Medavie Blue Cross has year of positive, progressive change

Posted by Shane Reid on February 11, 2020

From day one, over 75 years ago, we have applied bold thinking to our health benefit offering. We have evolved and innovated in the face of considerable change, with our commitment to best-in-class care and outstanding plan value an enduring constant.

In 2019, we delivered on that commitment by forming strategic partnerships, making calculated investments and harnessing the power of new technology to develop solutions that are reflective of and responsive to today’s realities. The result was a calendar year filled with product launches and service enhancements.

Here is a summary of our initiatives.

Digital Health

One of our proudest achievements in 2019 occurred when our new digital health care platform, Connected Care, went live in October. Exclusive to members of Medavie Blue-Cross benefit plans, Connected Care draws on the latest technologies and innovations to offer premium access to the best, most immediate care possible – and at preferred pricing. Services include Digital Therapy (iCBT), On-Line Doctors, and Personalized Medicine.

  • Connected Care was visited by more than 50,000 members in its first three months.
  • Average wait time to see a Canadian doctor on Connected Care is under two minutes with an average satisfaction rating of 4.9/5.

This is just the beginning! Watch for our online offering to expand in the coming months as we explore and embrace the most effective tools available to provide expedited and focused care.

Mental Health

Connected Care is just one way we are helping plan sponsors build psychologically safe, healthy and productive workplaces. In 2019, we also expanded our mental health practitioners benefit with higher maximum options and access to the services of a broader range of practitioners. As well, we added Internet-enabled Cognitive Behavioural Therapy (iCBT) to our Psychology/Social Worker Benefit to allow plan members to receive clinically-proven treatment for mild to moderate anxiety and depression from a licensed therapist by phone or video link - anywhere, anytime.

In 2020, we will continue to invest in Mental Health Solutions that make treatment more affordable and accessible, removing the barriers that prevent 60 percent of Canadians with mental health challenges from getting the expert help they need, such as cost, inconvenience and social stigma.

Chronic Disease

Chronic disease is responsible for more benefit plan spend than any other category – far exceeding that of specialty drugs – and increasing every year as new and expensive medications enter the market.

More than half of plan members (54 per cent) responding to the 2019 Sanofi Canada Healthcare Survey reported having at least one chronic condition, the top five being mental illness, hypertension, high cholesterol, arthritis and diabetes. Of those, 87 percent would like to know more about their condition and how to treat it, while 82 percent of plan sponsors would like to do more to help their members.

This is where health coaching and education services can play a vital role. Our Managing Chronic Disease benefit – a first for Canada – connects plan members with health professionals in their communities for one-on-one counselling to give them the knowledge and the confidence they need to take charge of their condition and improve their quality of life. Empowering employees to become full and responsible partners in their health care will remain a key focus of our efforts in 2020 and beyond.

Drug Adherence

Non-adherence to drugs is a huge and costly health care problem. Studies show that 20 to 30 percent of medication prescriptions are never filled and that approximately 50 percent of medications for chronic disease are not taken as prescribed. That’s why we added a Medication Management feature to our mobile app, Medavie Mobile (which by the way is one of the highest rated apps in the industry). This new functionality allows app users to get reminders on when to take their medication, refill their prescription, and to learn about the importance of medication adherence to their health.

Optional Benefits

We also employed the latest in web-based technologies to make sign up for our new Optional Benefits product quick and easy, resulting in a seamless, end-to-end experience for plan members that enable them to calculate their rates, choose their coverage and arrange payment - all online. The entire process can be completed in just minutes! Once their application is approved, they can rest easy, knowing they have extra financial protection against the impacts of a sudden, serious illness, injury or death.

Technology Upgrades

Still on the technology front, we completed the transition of our clients from our legacy system to our technology platform MAAX – one of the most innovative systems in North America in 2019. In addition, we introduced new telephone technology that integrates video, voice, messaging and more, to better serve our clients. We also continued to improve the user experience on the Group Administrator Portal in 2019, with more enhancements to come in 2020.

Pharmacogenetic Testing

We ushered in 2019 with the launch of a pilot project that taps the tremendous potential of Pharmacogenetics. This revolutionary tool in personalized medicine predetermines the safest and most effective drug therapies and dosages, with the least likelihood of adverse side effects, based on a person’s unique genetic profile or DNA. This in turn eliminates the costly trial-and-error process of choosing drugs that may or may not work for their patients, helping them to return to health and to work quickly and safely, confident in their treatment and recovery.

Our pilot invited disability claimants with a mental health or chronic pain diagnosis to take a voluntary pharmacogenetic test. The project has already shown impact in optimizing treatment for claimants and we look forward to sharing more outcomes from this initiative.. Stay tuned!

Drug Management

Given that Canada spent nearly $34 billion on prescribed drugs in 2018, up 4.2% from the previous year, and climbing, it’s imperative we keep pharma costs in line. Our Drug Management Solutions program is designed to strike that right balance between member access to effective treatment and sustainable cost for their plan.

At the centre of Drug Management Solutions is our Medication Advisory Panel, which takes an expert look at the health and cost implications of every drug considered for inclusion on our formulary. In 2019, MAP reviewed and made recommendations on more than 80 drugs.

In the coming months we will be introducing further enhancements to our proactive drug formulary to ensure we continue to stay ahead of change in the pharma landscape and seize current and emerging opportunities.

Opioid Crisis

Research indicates that non-medical use of prescribed opioids is now the fourth most prevalent form of substance use in Canada, behind alcohol, tobacco and cannabis. In November, we took steps to help address this health crisis by introducing additional formulary management controls that ensure safe access and appropriate utilization of opioids as part of our enhanced narcotic management strategy.

Fraud Management

Our comprehensive fraud risk management program, CrossCheck, incorporates organization-wide preventative, detective, investigative and enforcement controls and processes. In early 2019, we upgraded our predict analytics software to enhance our monitoring capabilities and isolate anomalies for further investigation.

It doesn’t end there. The increasingly complex and sophisticated nature of fraud schemes call on us to continuously strengthen our tools and practices to counter this trend and others we are seeing in the health insurance and health care space.

As an all-in-one carrier with in-house expertise, we have the flexibility to quickly adjust, adapt and innovate to the trends. Going forward, this will be essential to the vitality and sustainability of benefit plans we manage and insure for one in 12 Canadians. As Deloitte stated in a study on the future of health insurance, “nimble will be the new normal.” In 2020 and beyond, we will use our nimbleness to our advantage to keep pace – and stay ahead of the trends - building on the momentum that we created in 2019.

Cheers to all for a healthy and prosperous New Year!

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